Depression & Weight Gain
What IS Depression?
Like most psychiatric disorders, depression is an illness diagnosed and
characterized mostly by subjective symptoms and not by objective laboratory
tests or physical signs. This lack of "hard" findings has led many people to
question the validity of the diagnosis, but the features of depression, subjective
though they are, are highly distinctive and clustered. They include an inability
to derive pleasure from and a lack of interest in activities and events that used
to be fun, feelings of low self-esteem, difficulty with concentration, memory
loss, poor sleep, particularly a pattern of repeated nocturnal waking that lasts
hours, feelings of exhaustion, hopelessness and often obsession with thoughts
of death, self-harm and suicide. Depression can last for months or years and
can occur just once in a person's life, or repeatedly and can occur as a result of
personal loss like death or for no apparent reason.
The root causes of depression remain unknown but the illness clearly is related
to changes in brain chemistry and function that may either be triggered by
external psychological trauma or may occur spontaneoulsy.
Depression can be treated in several ways. Psychotherapy (talk therapy) clearly
improves depressive symptoms and so do anti-depressant medications,
particularly "selective serotonin re-uptake inhibitors"-(SSRI's) like Prozac.
Psychotherapy in combination with antidepressant medication works better than
either therapy alone but neither therapy alone or in combination is effective in
all cases. Severe depression that fails to respond to these modalities and that
puts a person at high risk for suicide is still sometimes treated with
"elctroconvulsive therapy"- (ECT)- performed under general anesthesia and this
can be effective when all other approaches have failed.
Untreated depression usually (but not always) resolves on its own eventually
but places a huge burden upon patients and family members of patients during
the time it remains active.
Major depression and atypical depression
have been strongly linked to obesity in a
number of recent studies. It remains
unclear whether depression causes
weight gain or weight gain causes
depression or the two disorders are
linked to an underlying common cause.
Since depression and weight gain are
both associated with feelings of low self
esteem, guilt, shame and hopelessness,
it is reasonable to argue that perhaps,
for some people, they truly are joint
manifestations of a common illness. At
present, all that can be said with
certainty is that many (but by no means
all) people who are depressed gain
weight and conversely, overweight
people are more likely to be depressed.
Depression Screening Questionaires
A number of simple questionaires have been developed in the last fifty years
to help screen for depression. Most are rather simple. I include one below
from the World Health Organization because it is among the most
straitforward. I have deliberately not included any information about how to
"score" results because I do not want people to attempt to establish a
self-diagnosis on this basis. If you believe you may be depressed, please
consult your health care provider.
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